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Anatomy

Lower Limb

Question 64 of 180

The tibialis posterior muscle is innervated by which of the following nerves:

Answer:

The tibialis posterior is innervated by the tibial nerve.

Posterior Leg Muscles

The muscles of the posterior leg are divided into the superficial group (the gastrocnemius, the plantaris and the soleus) and the deep group (the popliteus, the flexor hallucis longus, the flexor digitorum longus and the tibialis posterior).

Table: Function and Innervation of the Posterior Leg Muscles

Muscle Function Innervation
Gastrocnemius Plantarflexion of foot and flexion of leg Tibial nerve
Plantaris Plantarflexion of foot and flexion of leg Tibial nerve
Soleus Plantarflexion of foot Tibial nerve
Flexor digitorum longus Flexion of lateral four toes Tibial nerve
Flexor hallucis longus Flexion of great toe and plantarflexion of foot Tibial nerve
Tibialis posterior Plantarflexion and inversion of foot, support of medial arch Tibial nerve

Innervation

They are all innervated by the tibial nerve.

Function

The gastrocnemius plantarflexes the foot at the ankle and also flexes the leg at the knee.

The plantaris plantarflexes the foot at the ankle and flexes the leg at the knee.

The soleus plantarflexes the foot at the ankle.

The flexor digitorum longus flexes the lateral four toes. It is involved with gripping the ground during walking and propelling the body forward off the toes at the end of the stance phase of gait.

The flexor hallucis longus flexes the great toe and contributes to plantarflexion of the foot at the ankle joint.

The tibialis posterior inverts and plantarflexes the foot and provides dynamic support to the medial arch of the foot during walking. The tibialis posterior distally curves forward under the medial malleolus and enters the medial side of the foot to attach to the medial tarsal bones, mainly to the tuberosity of the navicular and adjacent region of the medial cuneiform.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Posterior Leg Muscles (Superficial): Gastrocnemius (green), Soleus (red), Plantaris. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Posterior Leg Muscles (Deep): Flexor Digitorum Longus (green), Tibialis Posterior (red), Flexor Hallucis Longus (blue). (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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